CRANSTON, R.I. -- Rhode Island officials canceled school yesterday and today for more than 20,000 students in three communities because of a suspected case of meningitis and the death of a second-grader from encephalitis.
Health officials are trying to determine whether the cases are connected. "Given the parents' concerns and our concerns, we felt that out of an abundance of caution we would keep schools closed," said Dr. David Gifford, head of the state's Public Health Department.
The case of suspected meningitis was reported late Wednesday in an unidentified student at Hopkins Hill School in Coventry. Health investigators are looking into whether the latest case is related to mycoplasma, an infection believed to have caused fatal encephalitis in a Warwick pupil and non fatal encephalitis in two other children in recent weeks.
Mycoplasma pneumonia, or "walking pneumonia," is the leading cause of pneumonia in school-age children, according to the federal Centers for Disease Control and Prevention. But it rarely leads to serious brain complications such as encephalitis, and death is even more rarely a result . Meningitis is an inflammation of membranes protecting the brain and spinal cord, and encephalitis is an inflammation of the brain.
Dr. Bela Matyas of the Massachusetts Department of Public Health said the Rhode Island cases do not present a risk to residents of Massachusetts. Mycoplasma pneumonia is nowhere near as contagious as flu. It is typically spread through close contact in families or settings where people spend many hours together, such as dormitories.
Epidemiologists from the Massachusetts health department and from the CDC are assisting Rhode Island in the investigation, talking to school nurses and looking for additional cases in hospitals. The CDC is testing samples to determine whether any other children have mycoplasma pneumonia; that test can take up to two weeks.
Investigators are also trying to determine whether the mycoplasma is a particularly virulent strain, said Matyas. If that is the case, authorities can prescribe antibiotics to halt the spread of the illness.
The closing of the schools affected students in three communities south of Providence: 11,500 in Warwick, 6,000 in Coventry, and 4,000 in West Warwick. There has been an unusually high incidence of pneumonia in the three communities, Gifford said.
In addition, the Catholic Diocese of Providence said eight schools in the three communities, with a combined 2,600 students, would be closed at least through today as a precaution.
Governor Don Carcieri said he would sign an executive order mandating certain hygiene procedures in schools, including disinfectant alcohol gels. "I cannot emphasize this enough : Do not be overly alarmed," he said.
Dr. Ken Waites, a professor of pathology at the University of Alabama, Birmingham, and chairman of the International Organization for Mycoplasmology, estimated that fewer than 5 percent of those with mycoplasma pneumonia that is severe enough to require hospitalization get encephalitis. But he said there could be more cases, because mycoplasma often goes undiagnosed and the government does not require doctors to report the illness.
"Someone [with mycoplasma] may not even seek medical advice" because the symptoms are so mild, he said. "They might just have a headache for a few days."
The child with the suspected case of meningitis was still hospitalized yesterday, Gifford said.
Dylan Gleavey, a second-grade pupil at Warwick's Greenwood Elementary School, died last month after mycoplasma progressed to encephalitis, officials said. A number of other pupils at the school have had pneumonia, and one of Dylan's classmates also suffered from a mild case of encephalitis but has recovered. A pupil at a West Warwick middle school was also infected but has recovered.
Alice Dembner of the Globe staff contributed to this report.